Evaluation of the feasibility of acetabular cup pre-determination in revision total hip arthroplasty via X-ray of the bone stock of the anterosuperior acetabulum
Abstract Purpose This study was aimed to explore (1) location on AP pelvic X-ray that displayed bone stock in anterosuperior acetabulum; (2) whether X-ray could provide enough evidence to evaluate whether bone stock could provide support for acetabular cup; (3) criteria to determine whether anterosu...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-021-02745-3 |
| _version_ | 1798042832240377856 |
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| author | Jingwei Zhang Keyu Kong Yingjun Chi Xiaoliang Liu Yiming Zeng Huiwu Li |
| author_facet | Jingwei Zhang Keyu Kong Yingjun Chi Xiaoliang Liu Yiming Zeng Huiwu Li |
| author_sort | Jingwei Zhang |
| collection | DOAJ |
| description | Abstract Purpose This study was aimed to explore (1) location on AP pelvic X-ray that displayed bone stock in anterosuperior acetabulum; (2) whether X-ray could provide enough evidence to evaluate whether bone stock could provide support for acetabular cup; (3) criteria to determine whether anterosuperior bone stock could provide sufficient support for cup on X-ray. Methods Our study retrospectively collected 43 patients who underwent revision THA for cup loosening from 2014 to 2019. The position of anterosuperior acetabular bone stock was compared between X-ray and CT-based 3-D reconstruction. Seventy-millimeter acetabular cup was implanted simulatively to obtain the contact line between acetabular cup and superolateral remaining bone stock. The contact line length and the angle were measured. Patients were divided into cup group and cage group, and ROC curves of both contact line length and angle were drawn. Results The superolateral part of acetabulum on X-ray could reflect the anterosuperior host bone stock of acetabulum according to the comparison of anteroposterior pelvic X-ray and 3-D reconstruction. Critical point was chosen when we got the highest sensitivity with a 100% specificity in ROC curves. The critical values of contact length and angle were 15.58 mm and 25.5°. Conclusions Surgeons could assess the anterosuperior bone stock of acetabulum by AP pelvic X-ray to decide whether revision could be done merely using cup or need customized cage. Clinically, when contact line length was larger than 16 mm or contact angle was larger than 25.5°, adoption of cup could obtain primary stability in the revision surgery in most cases. |
| first_indexed | 2024-04-11T22:41:07Z |
| format | Article |
| id | doaj.art-f9f7891fe43c487281580d5a834b4ee1 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T22:41:07Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-f9f7891fe43c487281580d5a834b4ee12022-12-22T03:59:01ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-10-011611710.1186/s13018-021-02745-3Evaluation of the feasibility of acetabular cup pre-determination in revision total hip arthroplasty via X-ray of the bone stock of the anterosuperior acetabulumJingwei Zhang0Keyu Kong1Yingjun Chi2Xiaoliang Liu3Yiming Zeng4Huiwu Li5Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineShanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineDepartment of Orthopedics, Shengzhou People’s Hospital (the First Affiliated Hospital of Zhejiang University Shengzhou Branch)Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineShanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineShanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineAbstract Purpose This study was aimed to explore (1) location on AP pelvic X-ray that displayed bone stock in anterosuperior acetabulum; (2) whether X-ray could provide enough evidence to evaluate whether bone stock could provide support for acetabular cup; (3) criteria to determine whether anterosuperior bone stock could provide sufficient support for cup on X-ray. Methods Our study retrospectively collected 43 patients who underwent revision THA for cup loosening from 2014 to 2019. The position of anterosuperior acetabular bone stock was compared between X-ray and CT-based 3-D reconstruction. Seventy-millimeter acetabular cup was implanted simulatively to obtain the contact line between acetabular cup and superolateral remaining bone stock. The contact line length and the angle were measured. Patients were divided into cup group and cage group, and ROC curves of both contact line length and angle were drawn. Results The superolateral part of acetabulum on X-ray could reflect the anterosuperior host bone stock of acetabulum according to the comparison of anteroposterior pelvic X-ray and 3-D reconstruction. Critical point was chosen when we got the highest sensitivity with a 100% specificity in ROC curves. The critical values of contact length and angle were 15.58 mm and 25.5°. Conclusions Surgeons could assess the anterosuperior bone stock of acetabulum by AP pelvic X-ray to decide whether revision could be done merely using cup or need customized cage. Clinically, when contact line length was larger than 16 mm or contact angle was larger than 25.5°, adoption of cup could obtain primary stability in the revision surgery in most cases.https://doi.org/10.1186/s13018-021-02745-3Bone defect assessmentX-rayRevision hip arthroplastyProsthesis selection |
| spellingShingle | Jingwei Zhang Keyu Kong Yingjun Chi Xiaoliang Liu Yiming Zeng Huiwu Li Evaluation of the feasibility of acetabular cup pre-determination in revision total hip arthroplasty via X-ray of the bone stock of the anterosuperior acetabulum Journal of Orthopaedic Surgery and Research Bone defect assessment X-ray Revision hip arthroplasty Prosthesis selection |
| title | Evaluation of the feasibility of acetabular cup pre-determination in revision total hip arthroplasty via X-ray of the bone stock of the anterosuperior acetabulum |
| title_full | Evaluation of the feasibility of acetabular cup pre-determination in revision total hip arthroplasty via X-ray of the bone stock of the anterosuperior acetabulum |
| title_fullStr | Evaluation of the feasibility of acetabular cup pre-determination in revision total hip arthroplasty via X-ray of the bone stock of the anterosuperior acetabulum |
| title_full_unstemmed | Evaluation of the feasibility of acetabular cup pre-determination in revision total hip arthroplasty via X-ray of the bone stock of the anterosuperior acetabulum |
| title_short | Evaluation of the feasibility of acetabular cup pre-determination in revision total hip arthroplasty via X-ray of the bone stock of the anterosuperior acetabulum |
| title_sort | evaluation of the feasibility of acetabular cup pre determination in revision total hip arthroplasty via x ray of the bone stock of the anterosuperior acetabulum |
| topic | Bone defect assessment X-ray Revision hip arthroplasty Prosthesis selection |
| url | https://doi.org/10.1186/s13018-021-02745-3 |
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